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Biomedical subjects

M Leroy

Publications and source records attributed to M Leroy.

At least 55 records · Page 3Linked to original sources
PubMed1992

Tracheal sleeve resection for iatrogenic stenoses (subglottic laryngeal and tracheal).

Since 1975 200 tracheal sleeve resections for iatrogenic tracheal and subglottic laryngeal stenoses have been performed in our institution. Preoperative Nd:YAG laser is of paramount help in opening the stenoses. Tracheography is usually performed to specify the length of the stenosis and the distance from the vocal cords. Operative procedures are described. One hundred seventy five (87.5%) patients are definitely cured, but in this group 16 patients required a Montgomery tube for 6 months to 1 year to recover a normal tracheal diameter. Two patients needed a second tracheal sleeve resection. Nine (4.5%) patients died, and 16 (8%) had recurrent stenoses. Stenoses in these patients were treated with use of a tracheostomy tube, a permanent Montgomery tube, or an endotracheal stent. Partial anterior cricoid resections performed in 21 patients have had the same results as those of the whole series. Twenty one laryngeal releases were performed and proved to be efficient and safe. In our experience complications can be avoided by good selection and preparation of the patients, accurate identification of the level and length of the stenosis, and meticulous technique.

Follow-Up Studies↗
PubMed1992

[Single lung transplantation].

Thirteen single lung transplantations have been performed in our department for non-infected end-stage lung diseases. Two patients died after surgery; a female patient died of uterine carcinoma one year and six months after the operation. The remaining ten patients are alive; they have resumed an active life and often working. The number of single lung transplantation is rapidly growing in the world, whereas heart-lung transplantation is regressing considerably.

Adult↗
PubMed1991

[Double lung transplantation. The "bilateral single" graft].

We present 10 cases of a new double lung transplantation technique: following, then the other, without requiring cardiopulmonary bypass. This "bilateral single" lung transplantation procures all the advantages of single lung transplantation.

Adult↗
PubMed1991

Lung and blood superoxide dismutase activity in mercury vapor exposed rats: effect of N-acetylcysteine treatment.

Rats were exposed to mercury vapors (30 mg/m3) for either 1 or 2 h. Histological lesions like alveolar oedema, hyaline membranes and sometimes fibrosis were observed. The lesions were more significant after 2 h of exposure, with about 50% of the animals dying within 2 weeks. The mercury level and the superoxide dismutase activity in the blood and the lungs demonstrated differences according to the time of exposure. In the animals exposed for 2 h to mercury vapors, N-acetylcysteine treatment increased survival time and the percentage of living animals. The lung superoxide dismutase was lower than in the non-treated animals indicating an antioxidant effect. Mercury levels were decreased in blood and lung, suggesting some chelating effect of N-acetylcysteine. The exact mechanism of its action must be further elucidated.

Acetylcysteine↗
PubMed1991

Histological and urinary reactivity of monoclonal antibody 1BE12 in bladder carcinoma. Purification of the antigen from urine.

We have previously reported the production of monoclonal antibody (MAb) 1BE12, which recognizes a glycoprotein in breast-cancer cells. In the present work, 1BE12 reactivity was tested by immunohistochemistry in bladder carcinoma (92 cases) and in non-tumoral bladder samples (15 cases). In 71% of bladder tumors, more than 30% of cells were intensely stained by 1BE12. The percentage of reactive cells was higher in cancers invading the muscle than in more superficial tumors (p = 0.039). In non-tumoral bladder, immuno-staining, when present, was usually confined to the superficial layers with a low number of cells stained (less than 30%) in 13/15 cases. Slot blots, performed on urine samples from 43 bladder-cancer patients and 21 healthy controls, were quantified by densitometry scanning. We found higher optical density (OD) values in urine from muscle-invasive-cancer patients than in urine from more superficial tumors and healthy controls, with a significantly different distribution (p = 0.005). The urinary antigen was detected by immunoblotting with 1BE12 as high-molecular-weight species (greater than 150 kDa). The reactive glycoprotein could thus be purified by immunoaffinity and FPLC filtration from the perchloric-acid-soluble fraction of urine from patients with invasive bladder carcinoma. The availability of purified antigen will allow us to quantitate our assay, in order to evaluate its potential use as a prognostic indicator in bladder-cancer patients.

Antibodies, Monoclonal↗
PubMed1990

Laser in bronchology: methods of application.

The method of application for the endoscopic resection by Nd-YAG-Laser closely depends on the choice of indications. The use of rigid bronchoscope is compulsory in the field of Laser, because of tracheobronchial obstruction in patients which are more or less on the verge of asphyxia. The resection is achieved under general anesthesia. A Nd-YAG-Laser (1.06 wavelength) with 100 watts maximum power is satisfying. The new 200 microns fibers are nearly perfectly flexible and increase the range of endobronchial laser-application. For some time we used a superpulsed mode of laser emission which obtains a real evaporation of tissues instead of carbonization. Cryotherapy may be useful before some resections to minimize bleeding. Endoprotheses can prolong the therapeutic effect of recanalization achieved by laser in end stage carcinomas.

Airway Obstruction↗
PubMed1990

[Detection of cancer of the prostate. A study of 600 cases].

A free screening consultation for carcinoma of the prostate was proposed to men over the age of 50 years working in different companies in the areas of Paris. This consultation included a digital rectal examination, a blood test for determination of serum acid phosphatase and prostatic specific antigen, and two dimensional trans-rectal ultrasonography of the prostate. 600 patients were seen. 575 were evaluable. Prostate biopsy was recommended in 152 men. Ninety-three prostate biopsies were performed. Eighteen prostatic cancers and 1 urothelial cancer invading the prostate were detected with an overall incidence of prostate cancer of 3.1%. Radical prostatectomies were performed in 10 of the 18 patients with a prostate cancer. Sensitivity of digital rectal examination ultrasonography and PSA were respectively 42.8%, 47.3% and 68.4% with an abnormal serum PSA level defined as being greater than 5 ng/ml. The predictive value of a positive ultrasonography (18.7%) contrasts with the predictive value of a positive digital rectal examination (30.7%) and serum PSA (30%). Digital rectal examination and determination of serum prostatic specific antigen seem to be the most useful tests for mass screening of prostate cancer. Transrectal ultrasonography is very useful for guided prostatic biopsy and for a better topographic evaluation of the tumor.

Aged↗
PubMed1989

Radioimmunodetection of lymph node invasion in prostatic cancer. The use of iodine 123 (123I)-labeled monoclonal anti-prostatic acid phosphatase (PAP) 227 A F(ab')2 antibody fragments in vivo.

The therapeutic indications in prostatic cancer depend on the regional and distant extension of the cancer and are difficult to assess before lymphadenectomy. Radioimmunodetection of lymph node involvement with monoclonal anti-prostatic acid phosphatase (PAP) antibodies can be proposed as a noninvasive alternative to lymphadenectomy. Fifteen patients with various stages of histologically proven prostatic cancer were examined by immunolymphoscintigraphy (ILS) before treatment to detect lymph node metastases. These patients had Stage A (n = 7), Stage B (n = 3), Stage C (n = 2), and Stage D (n = 3) tumors. They received between 100 and 400 micrograms of monoclonal antibody 227 A in the form of F(ab')2 fragments labeled with iodine 123 (123I). The antibody was injected directly into the periprostatic area. ILS images were obtained after 1, 3, 6, and 24 hours. Three days later, each patient underwent a lymphadenectomy for histologic examination. The results of the histologic examination and ILS were compared. In ten patients, the examination did not show any images capable of being interpreted as lymphadenopathy and histologic examination confirmed the integrity of the nodes examined. In five cases, scintigraphy suggested the presence of lymph node invasion by prostatic cancer and this was confirmed by histologic examination in three of the five cases. Overall, in terms of lymphadenopathy, this examination had a sensitivity of 100% and a specificity of 83%. Therefore, ILS appears to be capable of detecting lymph node metastases in prostatic cancer.

Acid Phosphatase↗
PubMed1989

[Critical analysis of 1000 systematic assays of serum levels of vitamin B12 and folates].

Between January 15 and April 30, 1988, one thousand assays of serum vitamin B12 and folates were performed, and the reasons why they were requested as well as their clinical usefulness are discussed. In 50 cases these assays were requested for a suspected myeloproliferative syndrome; in some of the patients with polycythaemia vera an excess of B12 was observed without hyperleukocytosis, an argument for keeping the B12 assay as an element of initial evaluation. In numerous cases the assays were performed for aetiological evaluation of a macrocytosis of suspected alcoholic origin in most patients; more than 50 per cent of the patient had folate deficiency and only a few had low B12 values. Folate levels were frequently low and B12 levels generally normal in patients with gastrointestinal disease, but many of them had been supplemented with folate and/or B12 prior to the assay. More than 20 per cent of the 1,000 assays were performed in patients aged 80 years or more, and more than 50 per cent of them had a low folate level; this has no consequences for individual subjects, but it may be of epidemiological or sociological interest. It must be mentioned that too many blood samples (more than 40 per cent) were sent to the laboratory without adequate information and after supplementation in 20 per cent of the cases. Very few patients with very low B12 levels were subjected to Schilling's test, so that the clinical usefulness of this assay, as currently utilized, is questionable in a large number of cases.

Adolescent↗
PubMed1989

Comparison of aminoglycoside concentrations measured in plasma versus serum.

The terms "serum concentration" and "plasma concentration" are often used interchangeably in therapeutic drug monitoring, but few studies have addressed the comparability of serum and plasma drug concentrations. Before implementing a change in the procedure for measuring aminoglycoside concentrations in our institution, we prospectively compared values for tobramycin and gentamicin concentrations measured in serum and plasma. For the 208 samples that were tested, plasma aminoglycoside concentrations were significantly lower than those in serum. This relationship was similar for tobramycin and gentamicin, and was unaffected by the presence of concurrent therapy with ticarcillin. This difference, while statistically significant, was not, in our estimation, of sufficient magnitude to be of clinical importance. Plasma aminoglycoside concentrations may be considered equivalent to serum concentrations and, owing to the shorter processing time involved, appear to be the preferred medium for measuring these values.

Aminoglycosides↗
PubMed1989

[Pulmonary papillomatosis].

The authors report a case of a 30 year old woman with juvenile laryngeal papillomatosis (JLP) who subsequently developed intra-alveolar papillomas. These papillomas demonstrated a marked pseudo-neoplastic loco-regional invasive activity, but did not possess the histological criteria of malignancy and were treated by pneumonectomy and lobectomy.

Adult↗
PubMed1989

[Initial results in man of immunolymphoscintigraphy of cancer of the prostate].

The loco-regional investigation of carcinoma of the prostate usually comprises ilio-obturator lymphadenectomy. This procedure carries a significant morbidity. Immunolymphoscintigraphy may provide a non-invasive alternative to this operation. Monoclonal (MAB) 227 A anti-prostatic acid phosphatase antibodies have been produced and selected for their affinity and specificity. This MAB was fragmented to its F (ab')2 form and marked with Iodine 123. Fifteen patients with prostate cancer were given 100 to 400 micrograms of the MAB by periprostatic perineal injection. The region was scanned 1 hr, 3 hrs, 6 hrs and 24 hrs after the injection. The results of the immunolymphoscintigraphy were compared with the histology of the ganglia removed at surgery or needle biopsy guided by CT scanning. In 13 cases the results were concordant for the two techniques (10 negatives and 3 positives). Two patients showed extra-prostatic fixation whilst the histology remained negative. Immunolymphoscintigraphy may therefore provide a simple method of detecting local metastases of carcinoma of the prostate if these initial results are confirmed.

Aged↗
PubMed1988

Levels and sub-cellular distribution of physiologically important metal ions in neuronal cells cultured from chick embryo cerebral cortex.

Mg2+, Ca2+, Mn2+, Zn2+, and Cu content of neurons from chick embryo cortex cultivated in chemically defined serum free growth medium was determined by energy dispersive X-ray fluorescence and atomic absorption spectroscopy. The intracellular volume of cultured neurons was determined to be 2.73 microliters/mg. Intracellular Mn2+, Fe2+, Zn2+, and Cu2+ in the cultivated neurons were 100-200 times the concentrations in the growth medium: Mg2+ and Ca2+ were 0.9 and 1.7 mM respectively, around 20 fold higher than in growth medium. Mg2+, Fe2+, Cu2+ and Zn2+ concentrations in neurons were in the range of ca. 300-600 microM, approximately 2-3 times the values previously reported in glial cells; Ca2+ and Mn2+ content of the neurons were higher by 5 and 10 fold respectively compared to glial cells. In neurons, the subcellular distribution of Fe2+, Cu2+, and Mn2+ follows the rank order: cytosol greater than microsomes greater than mitochondria; for Zn2+ the distribution differs as following: cytosol greater than mitochondria greater than microsomes. Determination of the superoxide dismutase activities in the cultivated neurons indicated that the Mn2+ linked activity predominates whereas, the Cu-Zn dependent enzyme is dominant in glial cells. Enrichment of the culture medium with Mn2+ to 2.5 microM enhanced the Mn-SOD by approximately 33% but the Cu2+-Zn2+ enzyme activity was not modified. The high Mn2+ content, the capacity to accumulate Mn2+, and the predominancy of the Mn-SOD form observed in neurons is in accord with a fundamental functional role for this metal ion in this type of brain cells.

Animals↗
PubMed1988

Concentrations of physiologically important metal ions in glial cells cultured from chick cerebral cortex.

Energy dispersive x-ray fluorescence and atomic absorption spectroscopy were used to determine the concentrations of Mg, Ca, Mn, Fe, Zn, and Cu in primary cultures of astroglial cells from chick embryo cortex in chemically defined serum-free growth medium. The intracellular volume of cultured glia was determined to be 8.34 microliter/mg protein. Intracellular Mn, Fe, Zn, and Cu in these cells were ca. 10-200 microM, or 20-200 times the concentrations in the growth medium. Mg2+ was 7 mM in glial cells, only four-fold higher than in growth medium. Glutamine synthetase (GS), compartmentalized in glia, catalyzes a key step in the metabolism of neurotransmitter L-glutamate as part of the glutamate/glutamine cycle between neurons and glia. Hormones (insulin, hydrocortisone, and cAMP) added to growth medium differentially altered the activity of GS and the intracellular level of Mn(II), but not Mg(II). These findings suggest the possibility that glutamine synthetase activity could be regulated in brain by the intracellular levels of Mn(II) or the ratio of Mn(II)/Mg(II), which may in turn be controlled indirectly by means of transport processes that respond to hormones or secondary metabolic signals.

Animals↗
PubMed1988

Prostate-specific antigen in prostatic cancer.

In an attempt to establish the value of prostate-specific antigen (PSA) in prostatic cancer, serum PSA measurements were performed in 600 patients, including 75 previously untreated prostatic cancer patients. The mean PSA levels in the benign prostatic hypertrophy (BPH) and cancer groups were highly significantly different, but less difference was found between BPH and localized prostatic cancer. A PSA level above 50 ng/ml was never recorded for BPH, but lower levels can be due to either prostatic cancer or to BPH. Our data suggest that PSA is not a specific marker of prostatic cancer but increased serum PSA levels must draw the physician's attention to the possible presence of prostatic cancer.

Antigens, Neoplasm↗
PubMed1988

Acute mercury chloride intoxication. Effects of hemodialysis and plasma exchange on mercury kinetic.

A 27 year-old man developed after ingestion of mercury chloride, 6 g, a hypovolemic shock, an acute renal failure and a necrosis of the stomach which required a total gastrectomy. The anuria did not improve and required 42 hemodialyses. Subsequent evolution showed numerous complications and the patient died on the 91st day. On admission mercury plasma concentration was 5 mg/L and decreased slowly with an apparent half-life of 226 hours. Hemodialyses were ineffective for mercury elimination: mercury clearances varied between -10 and + 1.5 ml/min. Seventeen mg of mercury were removed by six plasma exchanges: the mercury clearance was mean 17.3 ml/min. Among the extracorporeal elimination methods, plasma exchange appears to be the most efficient for inorganic mercury and it could be usefull in association with chelation therapy at the early phase of the intoxication.

Acute Kidney Injury↗
PubMed1988

[Prostate-specific antigen in prostatic pathology].

UNLABELLED: Prostate-specific antigen (PSA), like prostate acid phosphatase (PAP), are prostate tissue markers that are useful in prostate disorders. Increased PSA levels are often seen in carcinomas of the prostate, but have also been reported in benign inflammatory disorders of the prostate. We therefore studied PSA levels in 600 patients aged 22 to 89 years to evaluate the usefulness of this marker in prostate disorders. The 600 patients were divided into four groups: 120 normal subjects, 180 patients with carcinoma of organs other than the prostate, 75 patients with carcinoma of the prostate, and 225 patients with benign hypertrophy of the prostate. RESULTS: a significant difference in PSA levels was found between carcinomas and adenomas of the prostate, as well as between stage A carcinomas and adenomas of the prostate. Conversely, non significant difference was evidenced between stage A carcinomas and benign prostatic hypertrophy with inflammation. Rather than a specific marker for cancer, PSA indicates the presence of active prostatic disease, other investigations being necessary to determine whether this disease is malignant. PSA remains extremely useful for monitoring prostate carcinoma patients, especially following radical prostatectomy.

Adult↗